pharm Immunology

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Neda317
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231755
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pharm Immunology
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2013-09-12 07:27:39
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pharm
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  1. 2 types of acquired immunity
    • Natural
    • artificial
  2. 2 types of natural immunity
    • actively acquired 
    • passively acquired
  3. 2 types of artificial immunity
    • Actively 
    • Passive
  4. example of artificial --> actively acq
    antibodies produced through immunization, vaccine or toxoid
  5. example of artificial passive
    Injection of antibodies immune globulin
  6. example of Natural --> active
    having the disease
  7. example of Natural --> passive
    antibodies through placenta or breast milk
  8. Hepatitis
    B immune globulin
    Artificial passive immunity
  9. Measles,
    Mumps, and Rubella (MMR)
    • Artificially active immunity
    • Indicated to infants at 12 months old
  10. Measles,Mumps, and Rubella (MMR) is 
    Contraindicated
    in pregnancy why?
    it is a live vaccine
  11. Immunosuppressants
    and Immunomodulators
    • Immunosuppressants
    • drugs such as corticosteroids
    • suppress T-lymphocytes
  12. Lab
    Tests monitored before immunosuppressant drugs:
    • BUN and Cr
    • CBC
    • platelets
    • Hepatic enzymes
  13. Agents
    used during Organs transplant
    • 1.Cyclosporine
    • 2.Azathioprine
    • 3.Muromonab-CD3
    • 4.Sirolimus
    • 5.Tacrolimus
    • 6.Mycophenolate
  14. MOA

    Cyclosporine
    Binds to cyclophillin leads to decrease calcineurin --> inhibition of transcription factors --> decrease IL-2, IL-3, interferon-gamma
  15. Cyclosporine Ususally
    combined with
    corticosteroids
  16. corticosteroids

    Adverse
    effects
    • Nephrotoxicity
    • Gingival Hyperplasia
  17. MOA
    Azathioprine
    Converted to 6-Mercaptopurine                      --> Immunosuppression
  18. Azathioprine
    Adverse
    effects:
    • Leukopenia, thrombocytopenia,
    • hepatotoxicity
  19. what is Muromonab-CD3
    Monoclonal antibody
  20. Muromonab-CD3

    Indication
    -Acute renal transplant rejection
  21. Muromonab-CD3

    Must administer with what drug and why? 

    QQQQQQQQQ
    Must administer with methylprednisone before IV Muromonab-CD3  to preventcytokine release syndrome
  22. Sirolimus
    MOA
    it inhibits signal transduction
  23. Sirolimus

    Adverse effect
    Nephrotoxicity
  24. Sirolimus is metabolized by
    cytochrome P450
  25. Tacrolimus
    MOA
    calcineurin inhibitors
  26. Tacrolimus
    Indicated
    in renal and liver transplants
  27. Mycophenolate
    MOA
    inhibits de novo synthesis of purines
  28. Mycophenolate

    indication
    • Used
    • in combination with cyclosporine
  29. Agents
    serve to stimulate the immune response
    • IV immune globulin 
    • IM immune globulin
  30. Agentsserve to stimulate the immune response

    indication
    • Rx of congenital agammaglobulinemia
    • Rx of autoimune disease
    • Rx of Guillain-Barre syndrome
  31. Adverse
    reactions:

    immune globulin
    Hypersensitivity reactions
  32. Rh Incompatibility
    • Rh(-ve)mom
    • X Rh(+ve)dad
  33. 1.what to do
    If mom antibody screen is (-ve)
    • Answer RhoGAM at 28 weeks of pregnancy
    • and 72 H post partum if baby is Rh(+ve)
  34. RhoGAM
    • Human IgG to red cell Rho(D) antigen It
    • neutralizes Rh(+ve) so mom will not make antibody
  35. 2.what to do 
    If mom antibody screen is (+ve)
    • Don't
    • answer Rhogam.
    • Answer
    • titer measure.
  36. Why titer measure.?
  37. mom has been exposed already and this will go --> Baby --> hemolysis
  38. Cytokines 
    Interferon (Alpha)
    • Hepatitis,
    • leukemia
  39. Cytokines
    Interferon
    (Beta)
    Multiple sclerosis
  40. Cytokines
    Interferon
    (Gamma)
    Chronic granulomatous disease
  41. Cytokines
    Interleukin-11
    Thrombocytopenia (low platelet)
  42. Cytokines
    Thrombopoietin
    Thrombocytopenia
  43. Cytokines
    Erythropoietin
    Anemia
  44. Cytokines
    Aldesleukin
    (IL-2)
    Renal cell Carcinoma
  45. Cytokines
    Filgrastim
    (G-CSF)
    • bone
    • marrow recovery
  46. Cytokines
    Sargramostim
    (GM-CSF)
    • bone
    • marrow recovery
  47. Monoclonal antibodies:
    Abciximab
    • IIb/IIIa
    • receptors inhibitor
    • CAD
  48. Monoclonal antibodies

    Infliximab
    Rheumatoid arthritis
  49. Monoclonal antibodies

    Omalizumab
    Asthma
  50. Monoclonal antibodies

    Trastuzumab
    • Breast
    • Cancer
  51. Monoclonal antibodies

    Daclizumab
    Renal transplants
  52. Monoclonal antibodies
    Muromonab
    • Renal
    • transplants
  53. Monoclonal antibodies

    Palivizumab
    RSV
  54. Monoclonal antibodies
    Non-Hodgkin Lymphoma
  55. Monoclonal antibodies

    Adalimumab
    Rheumatoid Arthritis
  56. Monoclonal antibodies

    Bevacizumab
    Metastatic cancer
  57. Monoclonal antibodies

                   Rituximab
    Lymphoma
  58. Monoclonal antibodies

    Visilizumab
    Crohn’s disease
  59. Doctor Advice

    1.
    Staying home for 3m/old baby
    • Buzz
    • word: risk for low acquired immunity
  60. Doctor
    Advice

    2.
    Breast feeding even for short time
    • Buzz
    • word: will improve the baby's defense system
  61. Doctor
    Advice

    3.
    First immunoglobulin produced during infection:
    IgM
  62. Doctor
    Advice
    4.
    The only immunoglobulin that cross the placenta and
    provide the baby with passive immunity
    IgG
  63. A sedative drug, notorious for its teratogenic effects that have immunosuppressant actions and are useful in treating some forms of Hansen’s disease, multiple myeloma and cancer (due to anti-angiogenesis effects)?
    Thalidomide
  64. A female patient is brought to the the hospital for a lung transplant. Therapy begin with mycophenolate mofetil to prevent tissue rejection. Which of the following best describes the mechanism of action of this drug?
    Inhibits purine synthesis

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